When it comes to mental illness, no one is alone. That’s the message from the National Alliance on Mental Illness (NAMI), which reports that 51.5 million adults in the U.S. experienced mental health disorders in 2019. Put another way, that represents one in five people, the organization says.
That means you have a good chance of knowing and loving someone with a mental illness, including bipolar disorder, a condition “characterized by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks,” writes the National Institute of Mental Health (NIMH). According to its report, an estimated 2.8% of U.S. adults had bipolar disorder in the past year.
Understanding mental illness can be challenging for both the people who have it and those who love them. Loving someone with bipolar disorder will take empathy and patience as you learn how you can support them.
Your loved one must get professional treatment for their bipolar disorder as soon as possible. It is dangerous to ignore a mental health condition, as doing so can make it difficult to live life without complications.
If left untreated, bipolar disorder can cause any or all of the following:
- Substance use disorders (SUDs)
- Strained interpersonal relationships
- Poor performance at school or work
- Financial problems
- Problematic legal situations
Untreated bipolar disorder can also lead a person to harm themselves or others. Suicide or suicide attempts are also possible.
What Bipolar Disorder Is
Bipolar disorder is a mental disorder that affects the brain. As mentioned earlier, the disorder affects a person’s mood, energy and activity levels, and their ability to complete everyday tasks. If you have heard the term manic-depressive disorder or manic-depressive illness, these are other names for bipolar disorder.
Bipolar disorders bring sudden and dramatic changes in mood, which can be so extreme that they impair a person’s ability to think and reason properly. A person with the illness could be energetic at one point and then experience extreme depression at another point. This cycling of behavioral changes is unpredictable. As a result, some people with bipolar are prone to risky behaviors and suicidal tendencies.
NIMH identifies three types of bipolar: bipolar I, bipolar II, and cyclothymic disorder (cyclothymia).
Bipolar I involves manic episodes that last at least seven days. A person with bipolar I experiences periods of unusually high mood and high energy that disrupt their lives. Manic symptoms are so severe that they require immediate hospital treatment. People with this type of bipolar may also struggle to work or socialize with other people. They also are susceptible to experiencing psychosis, a mental illness that causes one to lose touch with reality. Bipolar I can include depressive episodes that last two weeks, and people can have depression and manic symptoms occur at the same time.
Bipolar II is the more common form. While it involves moods that can cycle high and low, a person with bipolar II does not have full-blown manic episodes. Instead, they can have periods of hypomania, a milder form of mania, and at least one depressive episode.
Cyclothymic disorder (cyclothymia) is a milder form of bipolar disorder that involves a person having many hypomanic symptoms and depressive symptoms. However, a person’s symptoms will not meet the diagnostic requirements for a hypomanic episode and a depressive episode, according to NIMH. There is also a specific timeline seen with this form of the disorder. The symptoms experienced must occur for at least two years in adults and at least a year in children and adolescents.
Understanding What Someone with Bipolar Disorder Experiences
One thing to understand about bipolar disorder is that it is a lifelong condition, so getting professional help is critical for the person who has it. Therapy and medication are used to treat the disorder, and these methods have helped many people live healthy lives.
People who want to support a person with bipolar disorder can educate themselves about the disorder’s symptoms, which fall into three main categories: mania, hypomania, and depression. Here are a few symptoms for each category that can give you an idea of what each phase looks like.
A person having a manic episode may experience:
- Bursts of energy or increased agitation
- Strong feelings of enthusiasm, happiness or excitement
- Anger, restlessness, or irritability
- Getting less sleep or not being able to sleep
- Having fast-paced thoughts
- Rapid speech, talking fast or talking more than usual
- Talking loudly
- Expressing speech that doesn’t make sense or is hard to understand
- Taking more risks or exhibiting reckless behavior
- Increased interest in alcohol, drugs, sex
- Inflated ego, self-esteem
- Excessive spending
According to Medical News Today, it may be hard for some people to calm down or think rationally during a manic episode.
Hypomania symptoms share similarities to manic episodes, but a combination of symptoms may be present. Medical News Today says hypomanic episodes must last for at least four days and include at least three symptoms from the list below. You may notice your loved one has:
- More energy or agitation
- Changes in appetite
- Decreased need for sleep or an inability to sleep
You also may notice they express rapid or racing thoughts or that they are talking faster than usual or talking more or louder than usual. Increased risk-taking or reckless behavior is also present. Usually, loved ones notice these behavior changes even though the person exhibiting them thinks all is well.
A person with bipolar who is in a depressive state often enters it after experiencing a manic or hypomanic state. Major depressive episode symptoms include:
- Less energy or fatigue
- Feelings of sadness, emptiness, hopelessness, or worthlessness
- Lack of interest in usual activities or hobbies
- Having trouble falling asleep, staying asleep, or sleeping too much
- Increased isolation
- Trouble concentrating or focusing
- Losing or gaining weight without dieting
- Having thoughts of suicidal thoughts or suicidal tendencies
Depressive episodes can be difficult to manage once a person exits a euphoric state, and their high energy levels have calmed down.
Helping Someone You Love with Bipolar Disorder
Bipolar disorder is a challenging mental illness. One reason is symptoms can surface suddenly after being absent for some time. Here are some ways you can support a loved one with the illness.
Help Your Loved One Find the Right Treatment. A bipolar diagnosis can be frightening and have your loved one feeling like they don’t know where to turn next. Be assured that there is help out there for all forms of bipolar disorder. Seek out the proper resources that can help your loved one learn all they can about their disorder. A good place to start is an accredited mental health facility that has the medical staff and resources available to evaluate your loved one and start the treatment process. A combination of medications, day treatment programs, substance abuse treatment and hospitalization can be used to treat bipolar disorder.
Plan for Unpredictable Mood Episodes. Get ahead of unpredictable bipolar episodes by making a plan for what to do when they happen. Sit down with your loved one and find out how they feel and what their thought process is when they have an episode. Together, you can figure out how you or other family or friends can support them at a critical time. You can discuss what to do in extreme situations that may involve self-harm or suicide or feeling a loss of control that can create a harmful situation.
Put the plan in writing, and make sure that everyone has a copy of it. You can keep it in a handy text or email or print it out and keep it somewhere that is easily accessible. Being a part of an emergency plan may require some emotional preparation on your part. While your loved one is rational while making the plan, it may feel like you are dealing with an entirely different person when it is time to execute it. A person with bipolar can be demanding, impulsive, and hard to talk to when they are in a manic state. Keep this in mind and figure out how you will deal with this if it happens.
Be a Good Listener. Sometimes, all we need is someone’s ear and understanding. If your loved one reaches out to talk, make some time for them. They may want to share with you what it’s like living with mental illness. Be sure to actively engage with them, making eye contact, and asking follow-up questions if needed. You can also be a source of optimism and encouragement for them. Acknowledge their efforts and let them know they are doing their best in living with this illness. Positivity can help boost their self-esteem and help them feel hopeful about tomorrow.
Educate yourself about bipolar disorder to help your loved one as much as possible, including your options for stepping away from it if it gets to be too much. There are times when helping your loved one cope with bipolar may be difficult for you. You can check out this list that Verywell Mind offers a list of supportive resources for people who are loving someone with bipolar.